According to the United States Centers for Disease Control and Prevention (CDC), an estimated 250,000 cases of bloodstream infections associated with central venous catheters occur each year in U.S. hospitals. These infections add approximately $25,000 in patient care costs per episode. In addition, the mortality associated with these infections is 18% or 45,000 deaths per years in the United States, see, CDC, Guidelines for the Prevention of Intravascular Catheter-Related Infections, Recommendations and Reports, Morbidity and Mortality Weekly Report, Aug. 9, 2002, Vol. 51, No. RR-10.
Various antimicrobial dressings have been used to prevent and/or reduce infections related to the uses of percutaneous devices. For example, BioPatch® Dressing from Johnson and Johnson is reported to reduce the incidence of catheter-related bloodstream infection by 60% and local infection by 44%. This polyurethane foam with chlorhexidine gluconate (CHG) may be used together with vascular percutaneous devices such as central venous catheters, arterial catheters, and PICC lines, as well as non-vascular percutaneous devices, such as orthopedic pins, epidural catheters, and drain tubes. It may continuously deliver the antimicrobial CHG for up to seven days and absorb up to eight times its weight in fluid. In addition, Acticoat 7 (with SILCRYST™ Nanocrystals) Antimicrobial Barrier Dressing provides an effective barrier to bacterial penetration, which may help reduce infection in partial and full thickness wounds. It contains a nanocrystalline coating of pure silver for delivering antimicrobial barrier activity to a dermal site, a rayon/polyester core for managing moisture level and controlling silver release, and a silver-coated high-density polyethylene mesh for facilitating the passage of silver through the dressing. It is reported that in vitro tests indicated that the Acticoat 7 dressing may be effective against more than 150 pathogens, such as, resistant strains of bacteria (e.g., antibiotic-resistant strains of Pseudomonas, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE)) and fungi.
Nonetheless, a number of factors limited the applications and/or the efficacies of the existing products. For example, it is well known that CHG can cause hypersensitivity reactions and has not been proven safe for pediatric applications. In addition, too much silver ions released from a dressing may cause dermal discoloration and may also be cytotoxic. Another drawback of the dressings currently known in the art is that these dressings have only point or two-dimensional contacts with a percutaneous device, leaving gaps between the dressing and the device and exposing the percutaneous device access site to potential pathogen attacks.
Therefore, there exists a need for an antimicrobial article for use with a percutaneous device having features, such as, providing a minimized or reduced gap between the article and the percutaneous device for reducing, minimizing, or eliminating infections related to the use of such percutaneous device, providing a sustained release of antimicrobial agents, facilitating the maintenance of optimal moisture balance, and/or being non- or less toxic, non- or less irritating, non- or less staining, and/or non- or less sensitizing.